Effect of Medication for Residual Symptoms in BPPV: Randomized Controlled Trials

Abstract

Objectives:

Even after successful canalith repositioning procedures (CRPs) in benign paroxysmal positional vertigo (BPPV), residual symptoms could be continued without positional nystagmus. The aim of this study was to evaluate the effect of adjuvant medication on residual symptoms after successful CRPs

Methods:

Between January 2011 and August 2012, 150patients with idiopathic BPPV participated. Patients who had previous history of psychiatric disorder or migraine were excluded. All participants were diagnosed by video-nystagmography (VNG), and Dizziness Handicap Inventory (DHI) questionnaires were completed before CRPs. All subjects were divided into three groups after successful CRPs. Medication (M) group was treated with vestibular suppressant (dimenhydrinate 25mg), placebo (P) group and no medication (N) group. One week after, all patients completed follow up VNG for recurrence and repeated DHI questionnaires for comparing residual symptoms.

Results:

All participants regardless of groups showed significant symptom improvement after successful CRPs, but 76 patients complained of residual symptoms. Presence of residual symptoms was more prevalent in P or N group compared with M group (P = 0.048, P = 0.03, respectively). Most frequent characteristics of residual symptoms were lightheadedness or mild headache (n = 36). However, in the analysis of DHI, total and subscale scores of DHI were not different between three groups before and after successful CRPs.

Conclusions:

Vestibular suppressant significantly reduced residual symptoms after CRPs. However, there is no significant reduction on DHI scores compared to a control group. It seems that residual symptoms may not be true vertigo but lightheadedness or headache.